If you fall from a ledge rock-climbing, break a leg backpacking in the wilderness or twist your shoulder paddling a remote river, hope like hell that Robin Pope will happen by.

Pope, an orthopedist assistant in Sylva and avid outdoorsman, has become the sixth person in North Carolina to earn the elite designation of Academy of Wilderness Medicine Fellow.

Pope, 46, is a physician assistant with Sylva Orthopaedic Associates. He’s also an outdoor enthusiast and a man who sets and meets goals, including earning a black belt in Kung Fu. That determination and drive allowed Pope to complete the rigorous standards for the Academy of Wilderness Medicine Fellow. He’s one of 200 in the world to have the designation.

“In the wilderness medicine arena, becoming an Academy of Wilderness Medicine Fellow is a pretty prestigious achievement,” said Loren Greenway, CEO and associate director of the Utah-based Wilderness Medical Society. “It takes a substantial investment of time, resources and energy to accomplish.”

Academy of Wilderness Medicine Fellows are often sought after for National Geographic expeditions, Greenway said.

Pope isn’t necessarily planning on take off on an exotic trip. He just wanted to be available to help if needed and to meld his professional life with his personal passions. Pope is an avid hiker and white water paddler, plus he’s a swiftwater instructor with the American Canoe Association.

“The program really provided some guidance on what experts in the field thought was important and gave direction in how to study that,” Pope said. “And also because I do meet people in the backcountry and I wanted to make sure I was as qualified (to help) as possible.”

To earn the Fellows designation, Pope logged countless hours in the field and classroom learning how to treat backcountry emergencies. He got in some real-life practice as well as a volunteer treating campers at Camp Daniel Boone, a Boy Scout camp at the base of the Shining Rock Wilderness. He also taught swiftwater rescue to other paddlers, plus did some training through Landmark Learning in Cullowhee.

If you get hurt in the backcountry or on a whitewater river, there aren’t x-ray machines, splints, Novocain, stretchers and other modern equipment to take care of an injury. That’s the biggest challenge to providing medical treatment in primitive settings, Pope said.

“If you hurt yourself right here, I’ve got all kinds of resources at hand,” said Pope, waving a hand around his office in Sylva Orthopaedic Associates. “If I don’t have what I need, I can pick up the phone and get it. But say we’re on the Chattooga River. I have to worry not only about what to do with you, but after that how are we going to get you out?”

Good decision-making is critical, too, Pope said. If a person goes to a doctor with abdominal pain, the doctor might tell him to wait a day. But if you were deep in the wilderness on an extended backpacking trip with, say, a possible 24-hour evacuation, decisions must be made more quickly than that. You simply don’t have the luxury of waiting to see how a possible appendicitis plays out.

“Most of what I use my skills for is to prevent the need to treat,” Pope said, explaining that in one case he had an asthmatic child so he turned back on a trip instead of continuing on. Sounds simple, but decisions like that can be lifesaving.

Being in the heart of whitewater country, Pope — an avid paddler himself — has treated other paddlers, usually for shoulder injuries.

“Some of it is common sense and some of it is just thinking about what bad stuff could happen and trying to be prepared for it,” he said.

Pope said his training as an Academy of Wilderness Medicine Fellow does help him in his regular job at Sylva Orthopaedic Associates, where he sees a lot of outdoor-related injuries. These include paddlers with their shoulder injuries and hikers with knee and ankle injuries.

“My outdoor training, plus this, helps understand how patients get here, and what they are likely to do when they go back to the activity,” Pope said. “I think that helps me do a much better job taking care of people.”

Pope also has received training through the Academy of Wilderness Medicine in recognizing diseases such as malaria, which might not be on the radar screen for most doctors trying to diagnose symptoms of an ill patient.

“Twenty-four hours ago, you could have been anywhere in the world and could have been bitten by a mosquito and gotten that exotic disease,” Pope said.

MedWest and Sylva Orthopaedic Associates have been highly supportive of Pope’s quest for the Academy of Wilderness Medicine Fellow, he said.

Pope next plans on pursuing the Academy of Wilderness Medicine’s Master’s Fellow degree program, an advanced certification for Academy of Wilderness Medicine Fellows who excel in a sub-discipline of wilderness medicine.

The backcountry experts

The Wilderness Medical Society is based in Salt Lake City. It is devoted to wilderness medical challenges and such wilderness medicine topics as expedition and disaster medicine, dive medicine, search and rescue, altitude illness, cold- and heat-related illness, wilderness trauma and wild animal attacks.